Fillable Please complete this form if you have attended (Columbia College)

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Please complete this form if you have attended (Columbia College)

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Please complete this form if you have attended another school in the United States
SECTION I:
This section must be completed by the F1 student transferring to Columbia College. Upon completion, give this form to the International Student
Advisor at the U.S. institution you currently attend or most recently attended. Please type or print clearly.
Last (Family) Name: First (Given) Name: __________________________
Current Mailing Address: _____________________________________________________________________________
City/State/Zip Code: _____________________________________________________________________________
Telephone: (_____) ______ - ________ E-mail Address: ____________________________________________
Date of Birth: Mo/Day/Year: ______ / _______/ __________
Current Immigration Status: F-1 Other If other, please indicate status:
Date of most recent entry into the U.S.: ______________________ Admission (I-94) number:
I hereby request and give my permission for the information below to be released to Columbia College of Missouri.
Signature: Date:
Section II:
The following information is to be completed by the International Student Advisor/Designated School Official at your
current school. The SEVIS code for Columbia College is KAN 214F 00119000.
SEVIS ID number: __________________________ Transfer Release Date in SEVIS: ________ / _________ / _________
Dates of enrollment: ________________________________________________
Student’s Current Program of Study: Associate Bachelor Master Other
Is/Was the student in good standing at your institution?
Yes No
If no, please explain: _____________________________________________________________________________
To the best of your knowledge, is this student eligible for a transfer of schools as addressed by 8 CFR 214.2 (f) (8)?
Yes No
If no, please explain:
I have reviewed the information above and it is accurate and true to the best of my knowledge.
Printed Name:
Email:
Title:
Phone:
Institution:
Address:
Signature:
Date:
Transfer Recommendation/Release Form
Columbia College of Missouri • International Admissions
1001 Rogers Street • Columbia, MO 65216
Phone: (573) 875-7352 • Fax: (573) 875-7506
Email: admissions@ccis.edu
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Please complete this form if you have attended (Columbia College)

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Completed 25 July 2020

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